Provider Demographics
NPI:1588813828
Name:JAIN, SHEETHAL NINA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEETHAL
Middle Name:NINA
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 CATKIN CIR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9637
Mailing Address - Country:US
Mailing Address - Phone:614-579-6304
Mailing Address - Fax:
Practice Address - Street 1:1913 CATKIN CIR
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9637
Practice Address - Country:US
Practice Address - Phone:614-579-6304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAN52403946084207L00000X
IN01071358A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology